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One minute, you’re happy, and the next, you’re fighting back tears. If your emotions seem harder to predict lately, you’re not alone. In fact, many women experience perimenopause or menopause mood swings.
“We know that up to 70 percent of women — if not more — experience mood swings during perimenopause,” Lauren Tetenbaum, a licensed psychotherapist and Menopause Society Certified Practitioner, told ThisIsMenopause. She wants women to know that help is available and that they don’t have to accept mood swings as a new way of life.
Here’s why mood swings happen during the menopause transition, what can help, and when it’s time to talk to your healthcare provider.
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Mood changes are common during the menopause transition, Tetenbaum explained, but they vary from person to person. For some, they’re subtle. For others, they can affect relationships, work, sleep, and quality of life.
Tetenbaum added that mood changes during menopause can feel similar to symptoms of premenstrual syndrome (PMS), including fatigue, irritability, and trouble concentrating.
“I get irritated at the littlest things now,” one member of ThisIsMenopause shared. “Hearing people talk, hearing noises, being asked to do anything. I feel like I’m losing my mind.”
Another wrote, “What bothers me most about mood swings is how I treat the ones I love.”
Others describe feeling angry, anxious, sad, overwhelmed, or unlike themselves:
If your mood changes feel different from these, that’s OK. Everyone experiences menopause differently.
“If you feel bad, volatile, ragey, irritable, or exhausted most of the time, just because it’s common doesn’t mean you have to live with that state of being,” Tetenbaum said. “It’s really important to get the support and treatment options that you deserve.”
When setting out to advocate for yourself, understanding why menopause can affect your mood is an important first step.
During the menopause transition, hormonal changes, midlife stressors, or a combination of the two can affect how you feel.
Fluctuating hormone levels can contribute to common menopause symptoms, including hot flashes, night sweats, insomnia, and mood changes, Tetenbaum explained. As the hormones estrogen and progesterone go up and down, it may feel like you’re riding an emotional roller coaster.
“A lot of women don’t recognize that what they’re experiencing emotionally is due to hormones,” Tetenbaum said. “They tend to think, ‘Maybe I’m just tired,’ or ‘Maybe this is my life now as a mom in her 40s,’ or whatever it might be. But, often, it is hormonally charged.”
While hormonal changes are often a big part of the picture, they’re not the whole story. Other factors can also contribute to mood swings during the menopause transition.
“Maybe you’re caregiving for aging parents or young kids or teenage kids. There could be career changes, relationship changes, impacts of the hormonal changes on sexual health, which of course has interpersonal effects,” Tetenbaum said. “Midlife is full of stressors.”
Accepting physical changes can also be difficult, whether they’re physical symptoms of menopause or age-related changes. New aches and pains, weight gain, or having less energy than before may cause sadness or grief.
Sometimes, mood changes can be a sign that something else is going on.
“Women in perimenopause are up to two to five times more likely to experience depression than in any other phase of their life,” Tetenbaum noted. “They’re at even higher risk if they’ve had a previous episode of depression.”
Tetenbaum explained that depression generally involves at least two weeks of persistent symptoms, such as feeling sad or tearful and losing interest in things that once brought joy.
Anxiety can also affect mood during the menopause transition. Symptoms may include excessive worrying, muscle tension, and difficulty sleeping.
Tetenbaum encourages women to pay attention when something feels new or different. They should speak up rather than waiting until symptoms become severe.
“If you are experiencing more lows than highs, then you should get help,” she stated. “You don’t need to be suffering in order to get help and support.”
What helps with menopause mood swings depends on what’s causing them. Your healthcare provider can help you create a plan based on your symptoms and health history.
Some people find that healthy lifestyle habits can help support their mood. These changes may include:
Limiting caffeine, sugar, and alcohol may be helpful, too, especially if they affect your sleep.
“If you don’t feel good, you’re not going to be your best self, emotionally,” Tetenbaum added.
Self-care can be difficult to prioritize when you’re balancing work, family, and other responsibilities. But making time for yourself isn’t selfish.
“During this phase of life, it is perhaps more important than ever to essentially demand the time and space for self-care,” Tetenbaum said.
Self-care might mean taking a walk, reading a book, spending time with friends, or simply having an hour when no one needs anything from you.
When you’re already feeling overwhelmed, a frustrating email, comment, or situation can trigger a stronger reaction than you intended.
Tetenbaum recommends pausing before responding when emotions are running high. Try stepping away, taking a deep breath, drinking some cold water, or splashing cold water on your face.
“When you’re feeling really elevated, whatever your initial response is, it’s probably not the ideal one,” Tetenbaum said. Giving yourself time to cool down can make it easier to respond in a productive way.
Letting your family know you’re having a difficult day can help them understand that your mood isn’t necessarily about them. And if you do react in a way you regret, acknowledging it and apologizing can help.
“We can control how we behave when we feel those emotions,” Tetenbaum said.
If tensions are high, consider postponing a difficult conversation until everyone is calmer.
Talking with a therapist, counselor, or another mental health professional may help you identify your triggers and develop strategies for managing difficult emotions.
“Many women find that psychotherapy like cognitive behavioral therapy can be an incredibly effective tool, whether they’re in perimenopause or not,” Tetenabum said.
Talk with your healthcare provider about treatment options. If menopause symptoms like night sweats and hot flashes affect your mood, your doctor might recommend hormone replacement therapy (HRT). HRT isn’t appropriate for everyone, though.
For depression and anxiety, your provider may recommend antidepressants or other medications.
“It’s important for women to understand that, yes, this is natural and normal and common, but it doesn’t have to be their new way of living,” Tetenbaum said. “There are treatment options available.”
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